Management of a perforated extensive ovarian tumor with radical resection and long-term tumor-free outcome: a case report
- 1Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Taleghani Boulevard, Taleghani Square, Karaj, Iran
Abstract
Background: Serous borderline tumors (SBTs) of the ovary typically follow an indolent clinical course. However, cases presenting with invasive peritoneal implants may exhibit aggressive clinical progression.
Case presentation: We report a diagnostically and surgically challenging case of a 37-year-old Iranian woman with a perforated, extensively disseminated SBT (International Federation of Gynecology and Obstetrics (FIGO) Stage IIIC) who achieved long-term disease-free survival. The patient initially presented with acute abdominal symptoms and septic shock. Intraoperative exploration revealed tumor involvement across multiple organs, including the uterus, gastrointestinal tract, omentum, and retroperitoneal vasculature. Management required an aggressive multivisceral resection, including an en bloc radical hysterectomy, rectosigmoid resection, small bowel resection, total omentectomy, systemic lymphadenectomy, and iliac vein reconstruction. The patient has remained clinically and radiologically disease-free for 3 years. This status was confirmed by regular follow-up evaluations, including surveillance Positron emission tomography (PET)/Computed tomography (CT) scans performed to rule out suspected residual or recurrent disease.
Conclusions: This case demonstrates that maximal cytoreductive surgery can achieve durable remission in select patients with advanced-stage SBTs and invasive implants. While this favorable outcome highlights the feasibility of aggressive surgical management, no definitive conclusions regarding overall prognosis or the standard role of adjuvant therapy can be drawn from a single case. Further studies are required to define optimal management strategies for this high-risk patient population.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13256-026-06496-9.
Related
- Ileorectal fistula after resection of perforated sigmoid tumor and Hartmann's procedure with uterine invasion: a case report.
- Emergency Resection for Perforated Small Bowel Metastasis from Primary Lung Cancer During Systemic Therapy: A Case Report.
- Operative Management of a Perforated Duodenal Diverticulum With a Retroperitoneal Abscess
- Sequential chemoradiotherapy vs. radiotherapy alone or concurrent chemoradiotherapy after radical resection of stage IA2–IIA1 cervical cancer: a retrospective cohort study
- Development and internal validation of a clinicopathological and CT radiomics based prediction model for extracranial distant metastasis after radical resection in early-stage non-small cell lung cancer
BibTeX
@article{farahani2026management,
title = {{Management of a perforated extensive ovarian tumor with radical resection and long-term tumor-free outcome: a case report}},
author = {Parham Khoshdani Farahani},
journal = {Journal of Medical Case Reports},
year = {2026},
month = aug,
doi = {10.1186/s13256-026-06496-9},
url = {https://doi.org/10.1186/s13256-026-06496-9},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Management of a perforated extensive ovarian tumor with radical resection and long-term tumor-free outcome: a case report
AU - Parham Khoshdani Farahani
PY - 2026
DA - 2026/08/12
JO - Journal of Medical Case Reports
DO - 10.1186/s13256-026-06496-9
UR - https://doi.org/10.1186/s13256-026-06496-9
AB - Background: Serous borderline tumors (SBTs) of the ovary typically follow an indolent clinical course. However, cases presenting with invasive peritoneal implants may exhibit aggressive clinical progression. Case presentation: We report a diagnostically and surgically challenging case of a 37-year-old Iranian woman with a perforated, extensively disseminated SBT (International Federation of Gynecology and Obstetrics (FIGO) Stage IIIC) who achieved long-term disease-free survival. The patient initially presented with acute abdominal symptoms and septic shock. Intraoperative exploration revealed tumor involvement across multiple organs, including the uterus, gastrointestinal tract, omentum, and retroperitoneal vasculature. Management required an aggressive multivisceral resection, including an en bloc radical hysterectomy, rectosigmoid resection, small bowel resection, total omentectomy, systemic lymphadenectomy, and iliac vein reconstruction. The patient has remained clinically and radiologically disease-free for 3 years. This status was confirmed by regular follow-up evaluations, including surveillance Positron emission tomography (PET)/Computed tomography (CT) scans performed to rule out suspected residual or recurrent disease. Conclusions: This case demonstrates that maximal cytoreductive surgery can achieve durable remission in select patients with advanced-stage SBTs and invasive implants. While this favorable outcome highlights the feasibility of aggressive surgical management, no definitive conclusions regarding overall prognosis or the standard role of adjuvant therapy can be drawn from a single case. Further studies are required to define optimal management strategies for this high-risk patient population. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13256-026-06496-9.
SN - 1752-1947
ER -